November 21, 2007
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In this month's issue:
How to talk to your doctor
New info you might have missed
Say what?! Basilar
How to talk to your doctor
It's such a major thing, and it's something we haven't thought about enough. How can we really communicate well with our doctors? And for you doctors reading this, how can you communicate well with your patients, and help them really tell you what you need to know?Earlier this year, a study was done in the USA called the American Migraine Communications Study II (AMCS II). This study is stimulating some useful discussion on the topic. Researchers, doctors and patients are talking about improving the lines of communication, and so improving treatment - now this is useful!
First, let's look at the problem. This study observed patients, doctors and nurses interacting. This was phase II - the first phase identified the problem. After a doctor's visit, the patient and the doctor have very different ideas about the migraine attacks. And they tend to think the other person knows things they don't.
For example, doctors are often afraid to ask open-ended questions. Instead of asking, for example,"how does migraine impact your life?" they might ask "how many attacks do you get per month?"
Doctors may be afraid that open-ended questions may lengthen the visit, and clutter it with irrelevant information. In fact, the second phase of the study showed that the office visits were actually shorter, and the doctors ended up having a lot more useful information.
So how should I talk to my doctor?
1) Don't just focus on how bad the pain is. Sure, you can tell your doctor that you feel like you were hit by a freight train, or that you feel like giant flaming pokers are being shoved into your skull, but don't stop there.2) Don't just tell your doctor how many attacks you have per month (like 1, 2, etc). They need to know that, but that's not the whole story.
3) Do tell your doctor how migraine impacts your life. If you miss work, tell her. If you cancel appointments, tell her. If you are constantly concerned about the next attack, or have trouble caring for your children, or feel you can't advance in your job, get proper exercise, or enjoy leisure activities, tell your doctor. How the attacks impact your life overall is much more important than temporary pain or the actual number of attacks.
4) Do assume your doctor wants to help. Don't be defensive (after all, you're in control - you can always go to another doctor!), instead help your doctor get the information she needs.
5) Do make sure your doctor understood. If you're a doctor, repeat back to your patient what you think they said (the researchers used the "ask-tell-ask" method - ask the question, listen to the response, and then ask again to be sure you understood).
6) Do ask about specific medications. Whether you have cluster, migraine, tension or sinus headache, research what medications are used for these. Too many patients are still getting non-specific drugs, when there are better drugs or better non-drug treatments available. Ask, and find out why your doctor is recommending a specific treatment.
7) Do make sure your doctor knows your medical history.
No matter what kind of disease or disorder you have, these are great tips. Good treatment is finished before it starts if there isn't proper communication. Try these things next time you walk into a doctor's office.
For more on this study and the ideas that are coming out of it, read Enhance Migraine Care by Stepping Up Physician-Patient Communication at Applied Neurology.
New info you might have missed
There's always something new at the website! Here are some of the recent additions that you may have missed:- For tension headache sufferers, a new article on Excedrin Tension Headache, a new headache-specific drug.
- A news story out yesterday about migraine brains.
- An Alzheimer drug that's being used for migraine, and a possible (new) reason why women may be more susceptible to migraine.
- Guest author neurologist Dr Marc Gotkine writes about Lupus and headache.
- The return of the migraine barometer
- And one oldie-but-goodie - head trauma from a sports injury.
Say what?! Basilar
The word basilar actually means referring to the base. When it comes to migraine and headache, we're usually referring to the basilar artery, a major artery at the base of the brain. But the trick is that basilar migraine, now called basilar-type migraine, may or may not be related to the artery. Usually attacking young adults, the basilar migraine is known for its strange aura symptoms. Read more about basilar-type migraine.Have a comment? A suggestion for a future topic? Drop by the HeadWay MailRoom and use your password, nomoache!